| Black Hills Center For Healing And Advancement Of Psychotherapy Plc | |
|
2525 W Main St Ste 303a6 Rapid City SD 57702-2437 | |
| (605) 440-2287 | |
| (605) 791-2086 |
| Full Name | Black Hills Center For Healing And Advancement Of Psychotherapy Plc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2525 W Main St Ste 303a6, Rapid City, South Dakota |
| Authorized Official Name and Position | Elizabeth Ostolozaga (OWNER) |
| Authorized Official Contact | 6054402287 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Hills Center For Healing And Advancement Of Psychotherapy Plc 2525 W Main St Ste 303a6 Rapid City SD 57702-2437 Ph: (605) 440-2287 | Black Hills Center For Healing And Advancement Of Psychotherapy Plc 2525 W Main St Ste 303a6 Rapid City SD 57702-2437 Ph: (605) 440-2287 |
| NPI Number | 1710442017 |
|---|---|
| Provider Enumeration Date | 01/31/2019 |
| Last Update Date | 01/31/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710442017 | NPI | - | NPPES |
| 2013208 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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